Centenary of nationwide free access to sexual health clinics in England and Wales

2017 marks the Centenary of a nationwide network of clinics for the treatment of sexually transmitted infections (venereal diseases as they were called) in England and Wales, a free and totally confidential service. Absolute confidentiality was enshrined in law and remains the hallmark of sexual health clinics today.

The journal Sexually Transmitted Infections (STI) celebrates this special year –together with the British Association for Sexual Health and HIV (BASHH) – of which STI is an official journal – with a range of specially commissioned content. They begin a series of historical vignettes reflecting the history of the journal and the profession, written by eminent physicians and scientists who reflect on a hundred years of progress. They will also be recording podcasts and look forward to joining BASHH at a London celebration in the summer. Make sure to keep an eye on the website and follow us on Twitter.

STI began in 1925 as the British Journal of Venereal Disease, and you can read early editions on the sti.bmj.com website. The very first issue covers skin complaints often mistaken for syphilis, the use of bismuth and malaria inoculation to treat syphilis, and the establishment of a network of clinics following a Royal Commission.1 It also discusses diathermy in the treatment of gonorrhoea!

A hundred years ago, we had no effective treatment for gonorrhoea, and it is sobering to realise we may soon be in the same position. The GRASP surveillance system which tracks antimicrobial resistance in England and Wales shows indications that we are not far from ceftriaxone treatment failures in a report by Town et al.2 In an age of nucleic acid based diagnostics, we need alternatives to culture for detecting resistance. A fascinating report by Graham et al reports that whole genome sequencing can be achieved with urine specimens, including the detection of markers associated with resistance.3 On a related note, this month’s editorial by Nigel Garrett reflects on the perhaps brief life of syndromic management.4Read full article